CHILDHOOD NUTRITION

INTRODUCTION Because children are growing and developing bones, teeth, muscles and blood, they need more nutritious food in proportion to their weight in comparison to an adult.

Malnutrition

, hence becomes very common when they have a prolonged poor appetite, or are fed with a limited number of foods which may be nutritionally poor foods.

NUTRITIONAL REQUIREMENTS FOR INFANTS

.
The

Recommended Dietary Allowances (RDA)

are based on the current knowledge of nutrient intakes needed by children of different ages for optimal health.

RECOMMENDED DIETARY ALLOWANCES FOR INDIANS (Ref Nin)

Group

Particulars

Body

WtKg

Net energy

kcal/d

Protein

g/d

Fat

g/d

Calcium

mg/d

Iron

mg/d

Vit.A.

µpg/d

retinol

Vit.A. pg/d

ß-carotene

Infants

0-6 months6-12 months

5.48.6

108/kg98/kg

2.05/kg1.65/kg

500

350

1200

Children

1-3 years
4-6years
7-9 years

12.2
19.0
26.9

1240
1690
1950

22
30
41

25

400

12
18
26

400
400
600

1600

25

400

25

400

2400

Boys

10-12 years

35.4

2190

54

22

600

34

600

2400

Group

Particulars

Body

WtKg

Thiamine

mg/d

Riboflavin

mg/d

Nicotinic

acid mg/d

Pyridoxine

mg/d

Ascorbic

acid smg/d

Folic

acid µg/d

Vit.

B-12 µg/d

Infants

0-6 months
6-12 months

5.4
8.6

55µg/kg
50µg/kg

65µg/kg
60µg/kg

710µg/kg
650µg/kg

0.1
0.4

25

25

0.2

Children

1-3 years
4-6years
7-9 years

12.2
19.0
26.9

0.6
0.9
1.0

0.7
1.0
1. 2

8
11
13

0.9

40

30
40
60

0.2-1.0

40

0.2-1.0

1. 6

40

0.2-1.0

Boys

10-12 years

35.4

1.1

1. 3

15

1. 6

40

70

0.2-1.0

The

Food and Nutrition

Board has recognized that human milk is the best food for infants and will meet the nutritive requirements early in life when it is supplied in sufficient quality. The nutrient allowances are stated.|

ENERGY :- The caloric need in an infant is high in terms of his body weight. The allowance of 130-150 Kcal per Kilogram for the infant at birth is necessary.

Eg : 130 Kcal/Kg.

Infant's birth weight = 3Kg.|

=> 130 x 3 = 390 Kcals.

Hence, the caloric need should be approximately 450 - 500 Kcal.

Since the activity of infants varies widely, an allowance that is correct for one infant may be too high or too low for others
PROTEIN :- The infant adds about 2.5 gm protein to his body after about 1.65 gm/kg per day for the rest of the year.

WATER :- The water loss from the skin is large because of the greater surface area in relation to body weight. Infants require about 150 ml water per 100 calories. This requirement is met by breast milk.

MINERALS :- Studies have proved that infants receiving human milk absorbed 50 - 60 percent of the total calcium, where as those receiving commercial formula absorbed about 25 - 30 percent of the total calcium.

The circulating hemoglobin of the well nourished infant is ample during the first three months, after which foods providing iron must be added in order to meet the needs of the expanding blood volume. The incidence of anemia is high in infants, usually appearing by the age of six months.

Although many trace elements are needed by the infant, the exact requirements have not been determined. It is safe to assure that humans milk will supply adequate amounts.

VITAMINS :- Human milk will furnish sufficient vitamin A & vitamin E

Human milk from the well - nourished mother supplies sufficient ascorbic acid for the infants needs, although supplements are generally introduced early.

The allowances for thiamine (B1), riboflavin (B2) and niacin (B3) have been set up proportionate to the caloric intake. These allowances are easily met by human milk.

The infant is born with a store of vitamin B6 that protects him during the neonatal period as human milk is very low in this vitamin.

BREAST FEEDING

IS THE BEST FEEDING FOR BABY Mother's milk is nature's gift to infants. Practically all mothers produce sufficient milk to meet the food requirementss of the normal infant for first three months. There is really no condition where breast- feeding is contraindicated. By and large from the time of birth upto the age of 3 months breast milk alone is adequate for the needs of the growing baby.

COLOSTRUM IS VITAL The thick yellowish breast milk, which is produced during the first 2-3 days after birth, is called colostrum. The colostrum contains less fat and lactose than mature milk and more sodium, chloride and zinc. It is rich in antibody protein especially immunoglobulin A(IgA) and lactoferrin. It guards the infant against infection. Feeding of colostrum is wrongly believed to be unhygienic in certain communities, perhaps due to its yellowish colour. Such practices should be stopped as it deprives the infant of its natural resources of nutrients and antibodies.

FEEDING THE INFANT Feeding on demand is recommended each time the baby is hungry. Duration of feeding varies from infant to infant and may range from 5-30 minutes and, or even more. The mother should be as comfortable as possible while Breast feeding. She should ensure that the baby's nostrils are not obstructed by the breast.The mother should feed the baby at one breast till the milk is totally sucked and then if the baby is still hungry,the baby should be fed at the other breast.This ensures increased milk production and also the baby recieves hindmilk which is rich in fat.

3. It has fats of short chain fatty acids which acts as irritants to the intestinal tract.

4. It has low contents of calcium, phosphorus, sodium and potassium but is easily absorbed.

4. It has higher contents of calcium,
phosphorus Na & K. Some healthy infants fed cow's milk have a
syndrome of convulsion known as neonatal tetany about the sixth
day of life. This is believed to be due to high blood phosphorus
level.

5. Ash content it three times less than in cow's milk.

5. Cow's milk has three times
more ash content than in human milk because of the lesser capacity of
the infant's kidney to excrete wastes, the high ash content of cow's
milk may prevent too high a solute load, which may cause diarrhoea.

WEANING FOODS (SUPPLEMENTARY FEEDING). There is no fixed /set pattern for adding solid foods to the basic milk diet of the infant. Once the infant has developed sufficient muscular co-ordination, involving the tongue & swallowing reflex to be able to eat solid foods, they may be introduced gradually.

INTRODUCTION OF NEW FOOD'S : -Some do's and dont's about introducing solid foods are as follows:

1 Introduce only one new food at a time to allow the infant to become familiar with that food before trying to give another.
2 Give very small amounts of any new food: one teaspoonful or two.
3 Use a very thin consistency when starting solid foods. Gradually consistency is more solid as the infant learns how to use his tongue in propelling the food back.
4 Never force an infant to eat more of a food than he takes willingly.
5 If after several times, it is apparent that a baby has an acute dislike for food, omit that item for a week or two and than try it again.
Food should be only slightly seasoned with salt, other seasonings are avoided.
7 Variety in choice of foods in important.
8 The mother or anyone feeding the infant should be careful to avoid showing dislike for a food given
9 Check that the temperature of the food is neither too hot nor too cold.

All
fruit juices may be given without adding sugar. Soups may
be seasoned only with salt and a dash of pepper. A blob
of butter may enhance the taste. Quantity may be increased slowly
to the acceptable limits.

Egg
should be boiled for a minute and immediately cooled under
running water to prevent discoloration. Gradually increase
quantity of egg yolk and include egg white. By 4 weeks from
the day the egg was introduced the child should be, able to
eat one whole egg.

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